From the Research
Mesenteric panniculitis is a rare, benign condition characterized by chronic inflammation and fibrosis of mesenteric adipose tissue, typically presenting with abdominal pain, bloating, nausea, and sometimes a palpable abdominal mass, and its diagnosis relies on a combination of imaging findings and histological confirmation 1, 2, 3.
Definition and Presentation
Mesenteric panniculitis is a rare inflammatory disorder affecting the fatty tissue of the mesentery, which is the membrane that attaches the intestines to the abdominal wall. It typically presents with nonspecific symptoms including abdominal pain, nausea, and weight loss, though it may be discovered incidentally. The condition results from chronic inflammation leading to fibrosis of mesenteric fat, though the exact cause remains unclear. Some cases are associated with autoimmune disorders, previous abdominal surgery, or malignancies, making comprehensive evaluation important for proper management 1, 2, 3.
Diagnosis and Treatment
Diagnosis relies on a combination of imaging findings, particularly the characteristic "misty mesentery" appearance on CT scan, and when indicated, histological confirmation. Treatment depends on symptom severity, with mild cases often requiring only observation. For symptomatic patients, corticosteroids like prednisone are the first-line treatment, with other medications including immunosuppressants such as azathioprine or cyclophosphamide, and tamoxifen which has anti-inflammatory properties 2, 4, 3. NSAIDs like ibuprofen may help manage pain and inflammation. In severe cases with bowel obstruction or other complications, surgical intervention might be necessary.
Key Considerations
- The condition is usually benign but requires thorough evaluation to exclude underlying malignancy and careful monitoring to prevent complications 1, 2, 3.
- Early recognition and appropriate management of mesenteric panniculitis are essential for optimal outcomes.
- Treatment should be guided by severity of symptoms and presence of complications, with surgery reserved for cases of recurrent bowel obstruction or diagnostic uncertainty 2, 5, 3.